Honolulu, Hawaii

, 2023


RE: H.B. No. 650

H.D. 2





Honorable Scott K. Saiki

Speaker, House of Representatives

Thirty-Second State Legislature

Regular Session of 2023

State of Hawaii




Your Committee on Judiciary & Hawaiian Affairs, to which was referred H.B. No. 650, H.D. 1, entitled:




begs leave to report as follows:


The purpose of this measure is to amend the Our Care, Our Choice Act to:


(1) Authorize advanced practice registered nurses to practice medical aid in dying in accordance with their scope of practice and prescribing authority;


(2) Authorize advanced practice registered nurses with a psychiatric or clinical nurse specialization to provide counseling to a qualified patient;


(3) Reduce the mandatory waiting period between oral requests from twenty days to five days; and


(4) Provide an expedited pathway for terminally ill qualified patients who are not expected to survive the mandatory waiting period.


Your Committee received testimony in support of this measure from the Department of Health, Board of Nursing, Hawaii Association of Professional Nurses, Compassion & Choices, Hawaii Pacific Health, Stonewall Caucus of the Democratic Party of Hawaii, Hawaii Society of Clinical Oncology, Hawaii Psychological Association, The Hawaiian Islands Association for Marriage and Family Therapy, and numerous individuals. Your Committee received testimony in opposition to this measure from Hawaii Family Forum and three individuals. Your Committee received comments on this measure from the Hawaii State Center for Nursing.


Your Committee finds that the Our Care, Our Choice Act allows mentally capable, terminally ill adults with six months or less to live to voluntarily request and receive prescription medication that allows the person to die in a peaceful, humane, and dignified manner. However, because of the State's unique geography and on-going physician shortage, qualified terminally ill adults are finding difficulty in receiving medical aid in dying. This measure increases access to medical aid in dying for qualified terminally ill patients by reducing the mandatory waiting period and authorizing appropriately qualified advanced practice registered nurses to administer medical aid in dying.


Your Committee has amended this measure by changing the effective date to upon approval.


As affirmed by the record of votes of the members of your Committee on Judiciary & Hawaiian Affairs that is attached to this report, your Committee is in accord with the intent and purpose of H.B. No. 650, H.D. 1, as amended herein, and recommends that it pass Third Reading in the form attached hereto as H.B. No. 650, H.D. 2.


Respectfully submitted on behalf of the members of the Committee on Judiciary & Hawaiian Affairs,